Background and Aims A thorough preoperative assessment of risk factors for complications in patients with hepatitis B virus (HBV)-cirrhosis undergoing laparoscopic cholecystectomy (LC) is of great clinical significance. Therefore, this study was conducted to investigate the risk factors for complications in patients with HBV-cirrhosis after LC for concomitant gallbladder stones.Methods The clinical data of 188 patients with HBV-cirrhosis and gallbladder stones who underwent LC from January 2016 to January 2020 were collected for retrospective analysis. The patients were divided into complication group and non-complication group according to whether there were postoperative complications. Univariate analysis and multivariate Logistic regression analysis were performed on the perioperative variables of the two groups of patients to determine the influencing factors for postoperative complications.Results Of the patients, postoperative complications occurred in 36 cases, and the overall incidence rate was 19.2%, in which, the incidence rates for Clavien-Dindo I, II and III (IIIa、IIIb) complications were 9.6% (18/188), 5.3% (10/188) and 4.3% (8/188), respectively, and no Clavien-Dindo IV or V complications occurred. The results of statistical analysis showed that there were significant differences in antiviral therapy, the presence of ascites, portal hypertension or hypersplenism, model for end-stage liver disease (MELD) score, operative time and intraoperative blood loss between complication group and non-complication group (all P<0.05). Logistic regression analysis showed that MELD score greater than 10 was an independent risk factor (OR=2.775, P=0.032), while antiviral therapy was an independent protective factor (OR=0.527, P=0.027).Conclusion LC is relatively safe for patients with HBV-cirrhosis. For these patients, antiviral therapy should be recommended before operation, and liver protection treatment should be aggressively administered to reduce the MELD score before operation in those with MELD score greater than 10.